Myofascial pain

Specialty of Orthopaedic surgery

What is myofascial pain syndrome?

Myofascial pain syndrome (MPS) is muscle pain in the body’s soft tissues and affects the musculoskeletal system. The chronic condition affects the fascia (connective tissue that covers the muscles) with certain areas being more sensitive than others. As pressure is applied to these trigger points, there is pain (known as "referred pain") in a different part of the body.
 

What are the symptoms?

The symptom of the condition includes muscle pain that feels like a firm knot, which is accentuated when moved. Myofascial pain syndrome gets worse or fails to improve over time. Muscles feel weak, stiff and inflexible and have a reduced range of motion. Due to the pain, there may be difficulty in sleeping, which may also affect a person’s mood.
 

What causes myofascial pain syndrome?

Normally, the myofascial pain is caused by overuse of the muscle, trauma (injury) or psychological stress. Other contributing factors may include bad posture, small lesions, soft tissue tension or rheumatic arthritis, gout, thyroid problems or psoriasis among other diseases.
 

How is myofascial pain diagnosed?

The doctor will perform a physical examination to look at the trigger points. They will press these points to check for any twitches in the muscles, which are also known as “jump signs”. The patient will also have to explain their symptoms and any past injuries to the doctor. The different types of trigger points are known as:

  • active trigger points - which are the source of muscular pain
  • latent trigger points – can remain dormant for years and are activated from stress or injury
  • secondary trigger points – becomes active when another muscle has been stressed
  • satellite myofascial point – this becomes active as it is next to another trigger point
     

Can it be prevented?

To prevent myofascial pain, it is advisable to maintain a good posture, avoid straining the joints and treat related diseases such as rheumatic arthritis.
 

What is the treatment?

In many cases of myofascial pain, the symptoms disappear on their own as is the case with many soft tissue syndromes such as tendonitis. Treatment will be based on reducing pain and inflammation, as well as on preserving mobility and preventing disability. Patients are usually prescribed anti-inflammatory drugs, muscle relaxants and pain relievers. Other recommended treatment methods may include:

  • dry needling – where the doctor inserts a needle directly into the trigger point and moves it around to reduce pain. This is not to be confused with acupuncture.
  • Trigger point injections – doctors inject saline or a local anaesthetic.
  • Ultrasound therapy – the machines transmit sound waves into the tissue through the gel that is applied to the skin. These waves heat up to relax the muscles and improve blood flow.
  • Massage therapy – this also increases blood flow and can reduce stiffness and pain.
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